Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy
Abstract Background Pancreatic ductal adenocarcinoma (PDAC) is a gastrointestinal tumor with high morbidity and mortality. Despite advances in diagnostic and therapeutic modalities, the outcome and prognosis of PDAC remain poor. Most patients have locally advanced disease (30%–35%) or distant metast...
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Springer
2025-03-01
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| Series: | Journal of Cancer Research and Clinical Oncology |
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| Online Access: | https://doi.org/10.1007/s00432-025-06147-4 |
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| author | Junqiang Dang Qingqiang Wang Yanling Yang Lin Shang Zeping Kang Yu Jiang Yanshun Ren Hongjun Xiang |
| author_facet | Junqiang Dang Qingqiang Wang Yanling Yang Lin Shang Zeping Kang Yu Jiang Yanshun Ren Hongjun Xiang |
| author_sort | Junqiang Dang |
| collection | DOAJ |
| description | Abstract Background Pancreatic ductal adenocarcinoma (PDAC) is a gastrointestinal tumor with high morbidity and mortality. Despite advances in diagnostic and therapeutic modalities, the outcome and prognosis of PDAC remain poor. Most patients have locally advanced disease (30%–35%) or distant metastases (50%–55%) at the time of diagnosis. The treatment of unresectable pancreatic ductal adenocarcinoma (UR-PDAC) remains an urgent problem. In this study, we report that a patient with UR-PDAC underwent significant tumor shrinkage after PD-1 inhibitor combination chemotherapy, and obtained R0 (pathologically negative margin) resection and long-term survival. Case presentation A 51-year-old woman was diagnosed with pancreatic cancer (stage III). She underwent 3 cycles of preoperative neoadjuvant therapy (NAT) with programmed cell death protein 1 (PD-1) antibody in combination with chemotherapy and the tumor shrank from 4.0 × 3.3 cm to 0.9 cm without significant adverse effects. The patient underwent conversion surgery (CS) and achieved R0 resection, and no tumor cells remained as confirmed by pathology. Conclusion PD-1 antibody combination chemotherapy regimens have significant efficacy and do not add additional side effects in UR-PDAC patients, heralding advances in UR-PDAC treatment. We may have a way to give UR-PDAC patients access to curative treatment and long-term survival. This case of UR-PDAC patient with PD-L1-negative and microsatellite stability (MSS) gives us a more comprehensive understanding of the treatment options of immune-combination chemotherapy. |
| format | Article |
| id | doaj-art-c34a7b5fcd8f4a2fb5ee76730d330e4e |
| institution | OA Journals |
| issn | 1432-1335 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Springer |
| record_format | Article |
| series | Journal of Cancer Research and Clinical Oncology |
| spelling | doaj-art-c34a7b5fcd8f4a2fb5ee76730d330e4e2025-08-20T01:52:01ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-03-0115141610.1007/s00432-025-06147-4Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapyJunqiang Dang0Qingqiang Wang1Yanling Yang2Lin Shang3Zeping Kang4Yu Jiang5Yanshun Ren6Hongjun Xiang7Department of Hepatobiliary Surgery, Xi’an Daxing Hospital Affiliated to Yan’an UniversityDepartment of Hepatobiliary and Pancreatic Surgery, Xijing Hospital Affiliated to Air Force Medical UniversityDepartment of Hepatobiliary and Pancreatic Surgery, Xijing Hospital Affiliated to Air Force Medical UniversityDepartment of Hepatobiliary Surgery, Xi’an Daxing Hospital Affiliated to Yan’an UniversityDepartment of Pathology, Xi’an Daxing Hospital Affiliated to Yan’an UniversityDepartment of Hepatobiliary Surgery, Xi’an Daxing Hospital Affiliated to Yan’an UniversityDepartment of Hepatobiliary Pancreatic and Splenic Surgery, Municipal People’s HospitalDepartment of Hepatobiliary Surgery, Xi’an Daxing Hospital Affiliated to Yan’an UniversityAbstract Background Pancreatic ductal adenocarcinoma (PDAC) is a gastrointestinal tumor with high morbidity and mortality. Despite advances in diagnostic and therapeutic modalities, the outcome and prognosis of PDAC remain poor. Most patients have locally advanced disease (30%–35%) or distant metastases (50%–55%) at the time of diagnosis. The treatment of unresectable pancreatic ductal adenocarcinoma (UR-PDAC) remains an urgent problem. In this study, we report that a patient with UR-PDAC underwent significant tumor shrinkage after PD-1 inhibitor combination chemotherapy, and obtained R0 (pathologically negative margin) resection and long-term survival. Case presentation A 51-year-old woman was diagnosed with pancreatic cancer (stage III). She underwent 3 cycles of preoperative neoadjuvant therapy (NAT) with programmed cell death protein 1 (PD-1) antibody in combination with chemotherapy and the tumor shrank from 4.0 × 3.3 cm to 0.9 cm without significant adverse effects. The patient underwent conversion surgery (CS) and achieved R0 resection, and no tumor cells remained as confirmed by pathology. Conclusion PD-1 antibody combination chemotherapy regimens have significant efficacy and do not add additional side effects in UR-PDAC patients, heralding advances in UR-PDAC treatment. We may have a way to give UR-PDAC patients access to curative treatment and long-term survival. This case of UR-PDAC patient with PD-L1-negative and microsatellite stability (MSS) gives us a more comprehensive understanding of the treatment options of immune-combination chemotherapy.https://doi.org/10.1007/s00432-025-06147-4Unresectable pancreatic ductal adenocarcinomaConversion surgeryChemotherapyImmune checkpoint inhibitorsNeoadjuvant therapyPD-1 antibody |
| spellingShingle | Junqiang Dang Qingqiang Wang Yanling Yang Lin Shang Zeping Kang Yu Jiang Yanshun Ren Hongjun Xiang Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy Journal of Cancer Research and Clinical Oncology Unresectable pancreatic ductal adenocarcinoma Conversion surgery Chemotherapy Immune checkpoint inhibitors Neoadjuvant therapy PD-1 antibody |
| title | Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy |
| title_full | Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy |
| title_fullStr | Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy |
| title_full_unstemmed | Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy |
| title_short | Case report: a case of R0 resection in a patient with PD-L1-negative, microsatellite-stabilized advanced pancreatic cancer after down-stage treatment with a PD-1 inhibitor in combination with chemotherapy |
| title_sort | case report a case of r0 resection in a patient with pd l1 negative microsatellite stabilized advanced pancreatic cancer after down stage treatment with a pd 1 inhibitor in combination with chemotherapy |
| topic | Unresectable pancreatic ductal adenocarcinoma Conversion surgery Chemotherapy Immune checkpoint inhibitors Neoadjuvant therapy PD-1 antibody |
| url | https://doi.org/10.1007/s00432-025-06147-4 |
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